Emergency C-sections temporarily reduced in Squamish

Staffing issues lead to reduction in services

Pregnant women in Sea to Sky will not be able to receive emergency C-sections at Squamish General Hospital (SGH) for one week out of every three until at least September. Women giving birth at SGH during those off-weeks are being transported to Lions Gate Hospital for the procedure.

Anna Marie D'Angleo, the senior media relations officer for Vancouver Coastal Health (VCH), said the problem is staffing related and will be temporary.

"We have two GP (general practitioner) surgeons in Squamish and they had been working on call every other week for the past 10 years," she said. "They wanted to reduce their on-call service to one week in three."

Another SGH physician has started enhanced surgical C-section training according to VCH. As soon as this individual's special skill training is completed, which is expected by the end of the summer, emergency, full time on-call C-section coverage will be restored.

The first week without C-section coverage took place June 11 to 17. According to VCH, who women were transferred to Lions Gate for delivery, although it's unknown if both received emergency C-sections. Future off-weeks include July 2 to 9, July 23 to 30 and Aug. 13 to 19, but more could be added.

D'Angelo said that SGH had 230 births last year, roughly 25 per cent of which were emergency C-sections. That is slightly more than one a week.

According to the SGH, roughly 25 to 30 per cent of all births at the hospital from 2007 to 2012 are C-sections — a figure that includes scheduled C-sections and repeat C-sections.

For 50 to 80 per cent of women giving birth vaginally at SGH. Roughly 20 to 50 per cent of women will encounter some medical difficulty, with roughly 50 per cent of those receiving an emergency C-section.

Because of the situation, D'Angelo said physicians and midwives are now evaluating their pregnant patients to determine who is high risk ahead of time. Women at a high risk of requiring a C-section are being referred to Vancouver hospitals, and encouraged to travel to the city when they go into labour.

Patients can still opt to be treated in Squamish, but have to sign a release form.

For low-risk women, the advisory warns that the decision to transfer women from SGH to Lions Gate will have to be made "sooner than we normally would."

It's estimated that the transfer will take 1.25 to two hours to complete, although it could be done faster in a situation where either the mother or baby are in danger.

In rare life-and-death emergencies — representing between two and three of every 1,000 births — SGH, Lions Gate Hospital and the BC Ambulance Service will coordinate their response. In the most serious cases women could be taken by air ambulance to the city.

In those cases, D'Angelo said the amount of time to get to a hospital in the Lower Mainland is roughly the same as it takes an on-call doctor to arrive and prepare for the procedure. "Really, the time is about the same," she said.

One Whistler doctor told Pique the health risk is unacceptable, and she will be counselling her pregnant patients to bypass Squamish completely and arrange to give birth in the Lower Mainland until the situation is resolved.